Icritical Care: All Audio

There is enormous heterogeneity in clinical outcomes and severity of septic shock, with some patients needing only supportive care in the ICU and others progressing to multiorgan system failure and death. How can clinicians identify patients at higher risk of death? In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn Bulloch, PharmD, BCPS, FCCM, is joined by John A. Kellum, MD, FCCM, to discuss high endotoxin activity as a possible endotype for septic shock. Dr. Kellum’s article, “Organ Failure, Endotoxin Activity, and Mortality in Septic Shock,” was published in the September 2025 compendium of Critical Care Explorations. Dr. Kellum is a professor and director of the Center for Critical Care Nephrology, as well as vice chair for the Department of Critical Care Medicine, at the University of Pittsburgh in Pittsburgh, Pennsylvania, USA. The study used a novel biomarker called the endotoxin activity assay (EAA) to detect endotoxin in the blood. While the EAA is not good at iden

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Maureen Madden, DNP, RN, CPNP-AC, CCRN, FCCM, speaks with Javier Varela, MD, MSc, about his study, “Acute Bronchiolitis in Infants on Invasive Mechanical Ventilation: Physiology Study of Airway Closure,” published in the September 2025 issue of Pediatric Critical Care Medicine. The study revealed new insights into airway pathophysiology in infants with severe bronchiolitis who require mechanical ventilation, a population that comprises a substantial portion of winter pediatric intensive care unit (PICU) admissions worldwide. Dr. Varela is an intensivist in the PICU in the Department of Pediatrics at Clínica Alemana de Santiago, in Santiago, Chile. Differing ventilatory strategies and the heterogeneous phenotypes of bronchiolitis motivated Dr. Varela’s team to investigate airway closure, which was detected in seven of the 12 patients included in the study. Airway opening pressure frequently exceeded the set positive end-expiratory pr

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with Nadir Yehya, MD, MSCE, an attending physician in the Pediatric Sepsis Program and the Division of Critical Care Medicine at the Children's Hospital of Philadelphia in Philadelphia, Pennsylvania, USA. They discuss Dr. Yehya’s study, “Parent and Provider Perspectives on Short-Term Outcomes of Critically Ill Ventilated Children,” published in the September 2025 issue of Pediatric Critical Care Medicine. The study explores whether widely used composite clinical outcomes such as ventilator-free days truly reflect what families value most when their child is in the pediatric intensive care unit (PICU). Dr. Yehya discusses how the project emerged from a long-standing question in pediatric critical care research: Are the outcomes we measure in clinical trials aligned with the priorities and lived experiences of families? Because mortality is low in pediatrics, composite short-term outcomes such a

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn N. Bulloch, PharmD, BCPS, FCCM, speaks with Olfa Hamzaoui, MD, PhD, professor of intensive care at Robert Debré Hospital in Reims, France, about her Peter Safar Honorary Lecture at the 2025 Critical Care Congress. The conversation centers on tissue perfusion, microcirculation, and shock, with a focus on bridging the gap between bench research and bedside practice. Dr. Hamzaoui shares insights on current scientific understanding of microcirculation and shock, including research on tools to monitor microcirculation, such as handheld video microscopy. The discussion highlights the utility of capillary refill time as a simple, noninvasive tool for guiding resuscitation. Dr. Hamzaoui advocates for early and repeated echocardiographic assessment in shock management, including during de-resuscitation. She also discusses her 2023 article in Clinical Medicine, which proposed titrating norepinephrine to individualized targets. This ep

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle B. Enfield, MD, FCCM, speaks with Sumeet Rai, PhD, FCICM, senior intensivist at Canberra Hospital, about his study, “Pawsitive Care: Canine-Assisted Intervention for Anxiety in ICU Patients and Family Members: A Single-Center, Single-Arm Study,” published in the May 2025 compendium of Critical Care Explorations. Dr. Rai explains how positive anecdotal experiences of animal therapy in the ICU inspired his team to conduct this study. Guided by infection control protocols, they implemented a program allowing accredited therapy dogs to visit patients and families for 15- to 20-minute sessions. More than 60% of patients and more than 90% of family members had a clinically meaningful reduction in anxiety scores, and patients reported decreased pain. No adverse events were observed, demonstrating the feasibility and safety of this approach. Dr. Rai addresses the study’s limitations, such as the impracticality of conducting a randomize

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with Rebecca Mitting, MD, MRCPCH, consultant pediatric intensivist and clinical lead for the PICU at Imperial College Healthcare NHS Trust in London. They discuss Dr. Mitting’s article, “Sedation and Ventilator Weaning Bundle and Time to Extubation in Infants With Bronchiolitis: Secondary Analysis of the Sedation AND Weaning in Children (SANDWICH) Trial,” published in the April 2025 issue of Pediatric Critical Care Medicine. The SANDWICH trial, conducted in the United Kingdom, evaluated a nurse-led intervention of sedation scoring, goal-based sedation weaning, and protocolized extubation readiness testing. While the original trial demonstrated only a modest reduction in ventilation duration, Dr. Mitting’s subgroup analysis of infants with bronchiolitis found a reduction of median time to successful extubation by approximately 16 to 17 hours. Dr. Mitting highlights the importance of these findi

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, speaks with Muhammad Mansoor Mohiuddin, MD, MBBS, DSc (Hon), FAST, director of the Cardiac Xenotransplantation Program at the University of Maryland School of Medicine, about his Thought Leader presentation at the 2025 Critical Care Congress, The Remarkable Potential of Xenotransplantation, and his groundbreaking work on that subject. Dr. Mohiuddin discusses the need to address the global shortage of donated organs and the use of genetically modified pig organs as a viable solution. He explains the science behind xenotransplantation, including the use of CRISPR-Cas9 gene editing technology to delete immunogenic pig genes and insert human-compatible genes. The conversation explores the unique immunologic challenges of xenotransplantation, particularly antibody-mediated rejection and the need for tailored immunosuppression protocols. Ethical considerations include religious perspectives

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn Bulloch, PharmD, BCPS, FCCM, speaks with Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation, about her Norma J. Shoemaker Honorary Lecture at the 2025 Critical Care Congress and the transformative impact of the 4Ms framework—What Matters, Medication, Mentation, and Mobility—on age-friendly critical care. Dr. Fulmer shares her journey from bedside critical care nurse to national leader in geriatric health, emphasizing the need to adapt healthcare systems to meet the needs of an aging population. She discusses the development of the Age-Friendly Health Systems initiative, a collaboration among the John A. Hartford Foundation, Institute for Healthcare Improvement, American Hospital Association, and Catholic Health Association. Now implemented in nearly 5000 facilities, the initiative is supported by evidence from models such as the Acute Care of the Elderly (ACE) units, Hospital Outcomes Program for Elder

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Samantha Gambles Farr, MSN, AG-ACNP, FNP-C, RNFA, speaks with Brian Boling, DNP, AGACNP-BC, FCCM, an advanced practice provider (APP) in the Department of Anesthesiology, Division of Critical Care Medicine, at the University of Kentucky and host of the Critical Care Scenarios podcast. They explore the challenges and opportunities facing novice nurses and APPs as they transition into new roles in critical care. Drawing from his own nontraditional path into nursing and advanced practice, Dr. Boling shares how self-directed learning—through podcasts, blogs, and social media—can supplement formal education and foster professional growth. He emphasizes the importance of building a personalized curriculum that balances foundational knowledge with emerging trends and encourages learners to focus not only on hot topics but also on the essential, everyday skills that drive patient outcomes. The conversation highlights strategies for identify

Mentorship can be transformative, especially for immigrant critical care professionals navigating unique career challenges. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Ludwig Lin, MD, speaks with Fajun Wang, MD, a neurocritical care specialist and assistant professor at St. Louis University School of Medicine, about his experience in SCCM’s Immigrant Critical Care Professional (ICCP) mentorship program. Dr. Wang shares his journey from medical school in China to building a neurocritical care service line in the United States, highlighting how mentorship shaped his path at every stage. He reflects on the challenges of entering a healthcare system in a new country and emphasizes the benefits of connecting mentors and mentees who share similar backgrounds and experiences. Dr. Wang’s ICCP mentor provided guidance during the launch of his ICU leadership role, offering insights into service line development and support during challenging situations. The ICCP program, developed from

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Diane McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, is joined by John Appino, MBA, founder and CEO of Contract Diagnostics, and Ryan Hakimi, DO, MS, NVS, RPNI, CPB, FNCS, FCCM, neurointensivist at Prisma Health in Greenville, South Carolina, for a conversation on salary and contract negotiations for advanced practice providers (APPs). The guests explore the nuances of evaluating job offers and negotiating compensation, as well as prioritizing onboarding, mentorship, and job fit. Dr. Hakimi shares insights from his leadership roles in academic neuro-ICUs and his longstanding advocacy for APPs, while Mr. Appino offers a strategic perspective on contract structures, compensation models, and negotiation tactics. The discussion highlights the variability in contract practices across academic and private institutions, the importance of defining full-time employment expectations, and the role of offer letters versus formal contracts. Listeners w

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Maureen Madden, DNP, RN, CPNP-AC, CCRN, FCCM, speaks with Jeremy Loberger, MD, assistant professor of pediatrics and medical director of the pediatric intensive care unit at the University of Alabama at Birmingham. Dr. Loberger shares insights from his work as lead author of “Implementing the Pediatric Ventilator Liberation Guidelines Using the Most Current Evidence,” and co-principal investigator of the multicenter collaborative Ventilation Liberation for Kids (VentLib4Kids), aimed at standardizing and improving extubation practices. Their conversation explores the evolving challenges of pediatric ventilator liberation, such as balancing extubation readiness with risks related to prolonged invasive mechanical ventilation and noninvasive respiratory support. Topics include the role of spontaneous breathing trials, pressure support strategies, sedation practices, and the impact of noninvasive modalities such as high-flow nasal cannul

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, welcomes guests Kaitlin M. Alexander, PharmD, BCCCP, and Ankit Sakhuja, MD, MS, FCCM, from SCCM’s Leadership, Empowerment, and Development (LEAD) Program, to discuss the use of AI in critical care education and clinical practice. Dr. Alexander is a clinical associate professor in the Department of Pharmacy Education and Practice at University of Florida. Dr. Sakhuja is the director of artificial intelligence and informatics at the Institute for Critical Care Medicine and director of clinical informatics research in the Division of Data-Driven and Digital Medicine. The discussion highlights how critical care educators and clinicians benefit from learning how to use AI and understanding its benefits and limitations. Incorporating AI into critical care education teaches students how to use AI responsibly in school and later in clinical practice. Clinicians should understand the utility o

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn N. Bulloch, PharmD, BCPS, FCCM, welcomes Matheus Bannach, MD, of Urgency Hospital of Goyes in the Eruseo-Dorne Cancer Hospital in Brazil. They discuss Dr. Bannach’s article, “Transfusion Practices in Traumatic Brain Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials,” published in the April 2025 issue of Critical Care Medicine. The study compared liberal and restrictive strategies for patients with traumatic brain injury (TBI). They found that a liberal transfusion strategy results in better neurologic outcomes than a restrictive strategy. Drs. Bulloch and Bannach discuss the importance of optimizing transfusion thresholds, the risks and benefits of blood transfusion for critically ill patients, and the limited supply of donated blood. The conversation also covers study methodology. Dr. Bannach explains the choice of main end point for the study, the process of selecting articles to include, and th

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle B. Enfield, MD, FCCM, welcomes Vincenzo Russotto, MD, of the University of Turin in Turin, Italy to discuss Dr. Russotto’s article, “Induction Agents for Tracheal Intubation in Critically Ill Patients,” published in the January 2025 issue of Critical Care Medicine. Drs. Enfield and Russotto explore the decision of which induction drugs to use for patients undergoing tracheal intubation. They discuss research challenges such as the ethics of which drugs can be tested on patients and the emergent nature of many tracheal intubations. Dr. Russotto discusses the advantages and disadvantages of ketamine as an induction agent and describes current clinical thinking on etomidate and propofol. His study made no definitive conclusions but found evidence that ketamine may have a safer profile and etomidate and propofol may be associated with negative effects. Dr. Russotto emphasizes the need to individualize patient treatment and shares e

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn N. Bulloch, PharmD, BCPS, FCCM, welcomes Bram Tilburgs, RN, PhD, of Radboud University Medical Center in Nijmegen, Netherlands. They discuss Dr. Tilburgs’ article, “Associations Between Physical, Cognitive, and Mental Health Domains of Post-Intensive Care Syndrome and Quality of Life: A Longitudinal Multicenter Cohort Study,” published in the January 2025 issue of Critical Care Medicine. The conversation offers key insights into the prevalence and long-term effects of post-intensive care syndrome (PICS). Dr. Tilburgs’ study surveyed intensive care unit (ICU) patients on their quality of life three months, twelve months, and two years after ICU discharge. The survey included physical, cognitive, and mental health domains. The findings show a significant link between PICS and diminished long-term quality of life. Drs. Bulloch and Tilburgs discuss how these results highlight the need for PICS prevention across all three domains

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Maureen A. Madden, DNP, RN, CPNC-AC, CCRN, FCCM, welcomes Christopher D. Newman, MBA, PA-C, FCCM, of Children's Hospital Colorado, and Victoria Howard, PA-C, of the University of Rochester to discuss professional advancement tracks for advanced practice providers (APPs). APP professional advancement programs aim to improve retention and engagement. Mr. Newman and Ms. Howard highlight additional benefits as well. They explain how the pilot professional advancement tracks at their institutions address specific needs of APPs. Mr. Newman’s program addresses the challenge of recognizing and supporting the nonclinical contributions of predominantly clinical faculty such as APPs. Ms. Howard’s program recognizes APPs’ careers beginning at an early stage and incorporates salary advancement into the program. The guests discuss the practical challenges of implementing a professional advancement model, including finding financial resources, obt

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, speaks with James R. Rodrigue, PhD, FAST, and Richard D. Hasz, MS, about their article, “Racial Equity in Family Approach for Patients Medically Suitable for Deceased Organ Donation,” published in the December 2024 issue of Critical Care Medicine. The study found racial equity in organ procurement organization (OPO) family approach among patients who were medically eligible for organ donation. Dr. Rodrigue and Mr. Hasz explain that previous studies showing racial disparity in family approach were based on 25- to 30-year-old data. The changes in organ donation systems since then were what motivated Dr. Rodrigue and Mr. Hasz to conduct new research. Their findings highlight the positive impact of standardized OPO practices on equitable access to organ donation opportunities. Dr. Rodrigue and Mr. Hasz emphasize the importance of timely referral, family-centered communication, and coordin

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with Anil Sachdev, MD, FICCM, of the Institute of Child Health, Sir Ganga Ram Hospital in New Delhi, India about his team’s study, “Transpulmonary Pressure-Guided Mechanical Ventilation in Severe Acute Respiratory Distress Syndrome in the PICU: Single-Center Retrospective Study in North India, 2018–2021,” published in the March 2025 issue of Pediatric Critical Care Medicine. Dr. Sachdev explains the development and implementation at his institution of a protocol for transpulmonary pressure (TPP) monitoring in pediatric patients with severe acute respiratory distress syndrome. His team compared outcomes of patients receiving TPP-guided ventilation with those receiving conventional mechanical ventilation. Study findings suggested that TPP monitoring enabled the use of higher positive end-expiratory pressure with greater clinician confidence, resulting in improved oxygenation. Study limitations i

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle B. Enfield, MD, FCCM, speaks with Garrett McDougall, MS, MSc, and Ben Forestell, MD, of McMaster University about their recent study, “Direct Laryngoscopy Versus Video Laryngoscopy for Intubation in Critically Ill Patients: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Trials,” published in the November 2024 issue of Critical Care Medicine. The study included 20 randomized controlled trials encompassing 4569 patients to investigate whether video laryngoscopy (VL) offers advantages over direct laryngoscopy (DL) for intubation in critically ill patients.  A key finding of the study was that VL probably improves first-pass success rates and reduces the risk of esophageal intubation and dental injury. These benefits extend across the spectrum of operator experience, especially among novice operators but also among seasoned operators.   Drs. McDougall and Forestell discuss findings that surprised th